Pericardial cysts usually result from a congenital malformation of the pericardial sac. Pericardial cysts are extremely rare, occurring in less than 1 out of 100, 000 cardiac patients (Elamin & Hannan, 2006). They are typically found incidentally as they are most often benign and non-problematic (Kraev, Komanapalli, Schipper & Sukumar, 2006). However, in 25% of patients, growth of the cyst can become troublesome resulting in symptoms. These patients present with varying degrees of symptoms including congestive heart failure, chest pain, dyspnea and cough; resulting from compression of the heart and lungs. Tamponade and right ventricular outflow obstruction are the most serious complications potentially causing life threatening emergencies and sudden death. Definitive diagnosis is achieved through either transesophageal echocardiography or computed tomography scan or magnetic resonance imaging. Surgical resection of the pericardial cyst is usually the management of choice. Less often, pericardial aspiration can be used as an alternative approach to this problem.